Step-by-Step Guide to Potty Training

Potty training might seem like a daunting task, but if your child is truly ready, there's not much to worry about. "Life goes on and one day your child will just do it," says Lisa Asta, M.D., a clinical professor of pediatrics at University of California, San Francisco, and spokesperson for the American Academy of Pediatrics. "When kids want to go on the potty, they will go on the potty. Sometimes that happens at 18 months, sometimes it doesn't happen until close to age 4, but no healthy child will go into kindergarten in diapers." So don't stress—your child will ultimately get on the potty and do his thing, but you can help guide the process along. If you're ready to make diapers a thing of the past in your house, experts recommend following these seven easy steps.

1. Introduce the Potty

Since kids typically start potty training between 18 and 30 months, start talking about potty training occasionally around your child's first birthday to pique interest. Keep a few children's books about potty training lying around your house to read along with your child. And bring up the subject of the potty in conversation; saying things like, "I wonder if Elmo [or your child's favorite stuffed animal] needs to go potty" or "I have to go pee-pee. I'm headed to the potty." The idea is to raise awareness about going potty and make your child comfortable with the overall concept before he's ready to potty train.

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2. Look for Signs of Readiness

If your child is staying dry for at least two hours during the day and is dry after naps, this could mean she's ready to give the potty a shot. Before you head to the bathroom, know that she can follow simple instructions, like a request to walk to the bathroom, sit down, and remove her clothes. Also make sure she's interested in wearing big girl underwear. Then consider if she's aware when she's wet: If she cries, fusses, or shows other signs of obvious discomfort when her diaper is soiled and indicates through facial expression, posture, or language that it's time to use the toilet, then she's ready to start the process.

3. Pick the Right Potty and Placement

Some children are afraid of falling in the toilet or just hearing it flush, says Maria Luisa Escolar, MD, a director at the Children's Hospital of Pittsburgh of UPMC. If your child is comfortable in the bathroom, try a potty seat that goes on top of your toilet to reduce the size of the bowl's opening. If not, you can buy a stand-alone potty chair and put it in the playroom or child's bedroom, where he'll become comfortable with its presence over time. When he's ready to give it a try, experts suggest you move it into the bathroom for repeated use, so you don't have to retrain your child down the road to transition from going potty in other rooms. Also get a stepstool—if he's using a potty seat, he'll need it to reach the toilet and also to give his feet support while he's pooping. "People can't empty their bowels and bladders completely unless their feet are pressing down on the floor," explains Scott J. Goldstein, M.D. a clinical instructor of pediatrics at Feinberg School of Medicine at Northwestern.

Even if your child seems ready, experts say to avoid potty training during transitional or stressful times. If you're moving, taking a vacation, adding a new baby to the family, or going through a divorce, postpone the potty training until about a month after the transitional time. Children trying to learn this new skill will do best if they're relaxed and on a regular routine. You might prefer to get potty training over with as soon as possible—maybe you're curious about the 3-day potty training trend. That's fine, experts say, but not if it becomes too frustrating. "I often see parents who boast that they trained their 2-year-old in a weekend, and then say that the child has accidents four times a day," Dr. Goldstein says. "This is not the same as being potty trained. When kids are truly ready, they often will just start going on the potty on their own."

When you do decide it's time to start potty training, you'll want your child to go to the bathroom independently, day or night, so make sure she has transitioned out of the crib and into a big-kid bed. "Kids need access to a potty 24/7 if they're potty training so they can reach it on their own when they need it," says Wendy Sue Swanson, M.D., a pediatrician at Seattle Children's Hospital. Keep a well-lit path to the bathroom so your child feels safe and comfortable walking there during the night. Of course, if you think you're child isn't ready for a big-kid bed (or, let's face it, if you're not ready), there's no harm in keeping her in diapers at night for a while longer. Talk to your child's doctor about the best time to potty train your child; the answer will range greatly by child, though most kids should be out of diapers during the day by age 3.

When you're ready to start training, let your child sit on the potty fully clothed when you are in the bathroom to get a feel for the seat. Then create a schedule: "The key is having times throughout the day where you ritualize using the potty so it becomes more of a habit," Dr. Swanson says. You might want to have him sit on the potty every two hours, whether he has to go or not, including first thing in the morning, before you leave the house, and before naps and bedtime. Tell him to remove his shorts or pants first, his underwear (or, if you're using them, training pants) next, and to sit on the toilet for a few minutes (allot more time, if you think he has to poop). Read him a book or play a game, like 20 Questions, to make the time pass in a fun way. Then, whether or not he actually goes potty, instruct him to flush and wash his hands. Of course, always praise him for trying.

It's not uncommon for a child who has been successfully using the potty for a few days to say he wants to go back to diapers. To avoid a power struggle or a situation where your child actually starts a pattern of withholding bowel movements, which can lead to constipation, you might agree to a brief break. But try to build in a plan to resume by asking your child, "Would you like to wear underwear right when you get up or wait until after lunch?"

When you're potty training, accidents are part of the process; some kids still have accidents through age 5 or 6, and many don't stay dry at night until that age (or even later). Never punish your child for wetting or soiling his pants; he's just learning and can't help it. In fact, doing so might only make your little one scared of using the potty, and that, in turn, will delay the whole process even further. Instead, when your child uses the potty successfully, offer gentle praise and a small reward. You might want to use a sticker chart—your child receives a sticker every time he goes potty; after he's earned, say, three stickers, he gets a small prize. "However, don't go nuts!" Dr. Goldstein says. "A lot of toddlers will react to excessive praise as they react to punishment—by getting scared and avoiding doing the thing that they were excessively praised or punished for." In other words, stick with stickers, a trip to the local park, or even a surprise cup of hot cocoa—no need to go on a shopping spree to Toys 'R' Us. Less tangible rewards, like finally living up to the promise of "being a big kid" are enough for some kids. Remind your child about the benefits of "being a big kid," like if he wore underwear, he would never have to stop playing in order to get his diaper changed.

7. Teach Proper Hygiene

To set children up with good hygiene habits that will last a lifetime, washing hands should be a routine from Day 1, along with flushing and wiping, regardless of whether your child actually went in the potty. The Centers for Disease Control and Prevention recommends wetting hands with cool or warm running water, lathering up with soap, and scrubbing for at least 20 seconds. Make hand washing fun by buying colorful kid-friendly soaps, and make it last long enough by singing a favorite song, like "Happy Birthday to You" or the "ABC Song," so the bubbles work their germ-fighting magic. Yes, toilet training can be stressful—for the parents, that is! But if you follow your child's lead, it won't be stressful for him.